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Overof human diseases, mainly infectious Cryptosporidium parvum oocysts ingested by mouth, there are two kinds of oocysts, a thin-walled oocysts
Cryptosporidiosis in its sporozoite invasion of the intestinal mucosal epithelial cells directly hatch, resulting in duplication of the host in vivo infection; another way for the thick-walled oocysts, the feces of people or other mammals after the infection. Cryptosporidium infection in more than normal performance for the self-limiting diarrhea, occurring mainly in infants and immunocompromised persons, can also be manifested as chronic intermittent diarrhea. AIDS patients suffering from Cryptosporidium enteritis more performance for the chronic non-self-limiting diarrhea, duration of more than 4 months, watery diarrhea, severe cases can was sprayed watery diarrhea, severe fluid loss, the average daily 3L, serious up to ten liters per day, mortality up to 50% more than the cause of death as dehydration and malnutrition. Survey of diarrhea caused by Cryptosporidium causes diarrhea in patients with AIDS accounted for more than 15%. Brady also found that Cryptosporidium can cause AIDS patients with pulmonary infection, manifested as interstitial lung disease, alveolar inflammatory exudate of patients and gastrointestinal Cryptosporidium was detected in a large number of trophozoites, despite a variety of treatment ineffective. There is no treatment of cryptosporidiosis in the effects of drugs, spiramycin drugs have a certain ef


fect, but there are no symptoms after the application of half of the patients improved. Certain effect of garlic is known as the domestic trial. Therefore, the treatment of Cryptosporidium enteritis is mainly supportive therapy, including diarrhea, rehydration and improve immune function. Description of Cryptosporidium disease (Cryplosporidium, Tyzzer, 1907) was a worldwide distribution. For the small size of the coccidia parasite.
Cryptosporidiosis has been a variety of vertebrates, including mammals, insects, birds, reptiles and fish are about the separation of more than 20 Cryptosporidium species. And the majority of them infected with Cryptosporidium parvum in mammals. According to their molecular biological characteristics, can be divided into 2 main types. One type includes insects strains isolated from the human body; another type of domestic animals are mostly isolated from the insect strains. Cryptosporidium is an important opportunity to cause diarrhea in human and animal pathogenic protozoa. Caused by the worm Cryptosporidiosis is a zoonosis. Human cryptosporidiosis in 1976, first reported by the Nime and Meisel 2 cases. Since then, with the insects and increased awareness of the disease and testing technology, the growing number of cases found. Form: The only insects infected with oocyst-oriented stage. Oocysts were round or oval, 4-6 m in diameter containing mature oocyst sporozoites were exposed and composed by the residue particles. Sporozoites were crescent-shaped. Difficult to identify without staining oocysts. The use of modified acid-fast staining, after being dyed blue-green background of the specimens, body is dyed pink. Since the oocysts in the samples out of different positions, observed in a microscope, the capsule was irregular arrangement of sporozoites. Residue is of a very dark black and brown particles. Life history: This insect life history is simple, the whole development process without the host conversion. Reproduction, including asexual reproduction (spore crack growth and proliferation of the body) and sexual reproduction (reproductive gametes) in two ways, both completed in the same host body. Developmental stages of both host intestinal epithelial cells in the page between the formation of cytoplasmic vacuoles within the insect is satisfied.
Cryptosporidiosis excreted with the feces of the host with infectious oocysts that. And susceptible animals are devouring the egg sac. The digestive process after the 4 sub spores escape capsule, the first attached to the intestinal epithelial cells, then invade cells in the body is satisfied that the proliferation of crack experts parasitophorous vacuole, the first development to trophozoite. After 3 mitotic schizonts develop into type . Type mature schizont with 8 merozoites. Mature merozoites are released, invade other epithelial cells, development for the 2nd generation trophozoites. 2nd generation trophozoites by 2 nuclear fission type schizont development. Type mature schizont with 4 merozoites in vivo, after the release of the merozoites develop into male and female gametophyte, the two combined form a zygote, the beginning stages of spore proliferation. Zygotes develop into oocysts and mature oocysts with 4 naked sporozoites. Oocysts are thin (about 20%) and thick (about 80%) of two types. Only a thin layer of unit membrane oocysts, the sporozoites escape the invasion of intestinal epithelial cells directly, still line the body breed crack that may cause infection in the host's own body duplication; thick-walled oocysts in intestinal epithelial cells or intestinal spore Canon of (the formation of sporozoites) in the capsule after the formation of 4 sporozoites. Excreted with the host feces. Thick-walled spores of infectious oocysts. Complete the entire life cycle takes about 5-11 days. Symptoms and signs, the severity of clinical symptoms in patients with immune states. Normal immune function after infection of the insects that often appears self-limiting diarrhea,
Cryptosporidiosis watery stool, a large amount of pain may have abdominal cramps, nausea, anorexia, fever and general malaise and other symptoms. Course of the disease usually lasts 1-2 weeks, the symptoms will gradually reduce or dissipated. Course in 1 month or more are relatively rare. Stable clinical symptoms, the patient was still fecal excretion of the oocysts for several weeks. Patients with abnormal immune function, as the gradual onset of disease, but often more severe the degree of diarrhea, stool per day up to 5-10L. If the status of the patient's immune defects are not corrected, will not be able to clear the infection. Diarrhea, long-term or even life to continue. Then lead to nutritional malabsorption, extraintestinal tissues or even organs, such as lung and biliary infection. In sputum samples of lung tissue and in bile Richard parasites. Particularly noteworthy is that people with AIDS, Cryptosporidium is a common intestinal infection combined pathogen infection often endanger the lives of patients. Haiti and Africa in Europe 50% of AIDS patients complicated by infection of the insect and cause diarrhea. U.S. infection rate of 8% -37%. (Vakil, 1996) and most of intractable diarrhea. AIDS patients with Cryptosporidium infection caused by diarrhea, cholera-like watery diarrhea showed a day up to ten times, and watery diarrhea per day, or up to 3-6L. Up to 17L, which can cause patients with severe dehydration, electrolyte imbalance and malnutrition. Ultimately a result of systemic failure and death. Therefore, the current inspection of foreign Cryptosporidium has AIDS patients as a routine examination.
Cryptosporidiosis 1. Acute gastroenteritis type: infection of normal immune function and more manifestations of acute gastroenteritis. Diarrhea, 4 to 10 times a day, paste it, or water, sometimes a small amount of pus and blood, may have odor. Often accompanied by abdominal discomfort, pain and even nausea and vomiting. Part of the fever. Self-limiting disease, more natural remission within 2 weeks. No recurrence, the prognosis is good. 2. Chronic diarrhea: mainly seen in the immune dysfunction, especially AIDS. Slow onset, delayed healing of diarrhea, watery stools, the amount of more than 10 liters per day ranged from 1 day, 10 times or so. Occasional bloody stools, and more with abdominal pain, prone to dehydration, acidosis and hypokalemia, vitamin deficiency and so on. Sustainable course of 3 to 4 months or 1 year or more, can be recurrent. 3. Immunocompromised persons Cryptosporidium disease: The incubation period is difficult to determine. Symptoms are many and heavy, long duration. Patients with cholera-like diarrhea, often, at up to ten times, and amounted to an increased 10 L / d, patients often have water and electrolyte disturbance and weight loss, and even showed cachexia. Cryptosporidium can still be caused by laryngeal tracheitis, pneumonia and other respiratory tract infections, which can with cards Pneumocystis carinii pneumonia, cytomegalovirus infection, X-ray examination showed increased lung markings deep, interstitial pneumonia. Gallbladder infection found in 10% AIDS patients with cryptosporidiosis, manifested as acute cholecystitis or sclerosing cholangitis, the patient may not have diarrhea; the disease associated with pancreatitis and hepatitis are also seen, from the bile, pancreatic juice, bile duct or liver biopsy Cryptosporidium found in epithelial cells can be confirmed. Disseminated cryptosporidiosis is often found at autopsy. Cause of a disease, of infection and infection of Cryptosporidium oocysts and can discharge a variety of animals, are the of infection of this disease. The current
That the disease cryptosporidiosis in patients, especially children and patients who are asymptomatic parasite main of infection of this disease. Another of infection for the infected animals. Bovine-based rural, urban Zeyi pets such as dogs, cats as the reservoir hosts. Asymptomatic cyst are easy to cause ovulation schools, kindergartens and other collective life of people infected per capita. 2, the transmission of the disease spmainly through the digestive tract. Since swallowing contaminated by oocysts and infected food or water. Water pollution can cause an outbreak of epidemic. As the patient's throat and sick animals, nasal secretions and sputum in both the presence of Cryptosporidium oocysts and, therefore, by oral secretions or droplets. Can lead to direct transmission due to homosexual. Playing with an infected person can also be pet cause infection. 3, the susceptible population groups susceptible to the disease in general, have more opportunities to with infected animals or patients (such as pastoralists, nurses), there is reference to the raw water used (such as reference to contaminated water, surface water), and the young higher infection rates of children. Susceptibility of infants and children under two years of age than older children, immune defects (such as Ai Zi patients (or by transplant recipients (such as long-term immunosuppression, oncology patients) the prevalence and incidence of particularly high. After infection, serum antibodies can be arbitrary between the anti-IgA, IgG and IgM, these antibodies may have a protective effect of the host, or can reduce the severity of re-infection.
Cryptosporidiosis and 4, were popular features of Cryptosporidium worldwide distribution of population in developing countries than in developed regions in the population prevalence rate of infection is high. Different incidence of the season in order to more incidence of summer and autumn. And rural areas than in urban, mostly sporadic in the collective body may also be such as troops, preschools are not only presented a small pop, and new families gathered, but also one of the reasons travelers diarrhea. Diarrhea patients in the developing and developed countries, the prevalence of cryptosporidiosis were 3% -13% and 0.6% -7.3%. National infection rate was 1.4% -13.3%. Chronic diarrhea was significantly higher than that of Cryptosporidium infection in patients with acute diarrhea. The crowd around the epidemic and the social customs, living conditions, living standards and health conditions, are also closely related. The exact pathophysiology of the pathogenesis of this disease is not very clear, most people think may be due to extensive damage of intestinal epithelial cells and villous atrophy caused by malabsorption results. It was speculated that the possible Cryptosporidium parvum toxin, they found that Cryptosporidium parvum infection in calves with fecal supernatant of toxin-like activity. The course of a lot of water and electrolyte loss is small intestinal mucosa and intestinal disorders caused by damage. In addition the intestine and other mucosal disaccharidase enzymes and reduce the loss, but also one of the reasons causing diarrhea. Was found infected with Cryptosporidium parvum from intestinal epithelial cells, prostaglandin E2 stimulate active Cl-secretion and the role of inhibition of neutral NaCl absorption.
Cryptosporidium cryptosporidiosis in humans and animals caused by similar pathological changes, lesions were found in the small intestine and colon, stomach and esophagus may also be involved. Intestinal lesions of villous atrophy or even disappear shorter crypt crypt epithelial cell proliferation was significantly better at the same time, mucosal surface of epithelial cells were short columnar, arranged in irregular nuclei, villi epithelium and lamina propria mononuclear cells were seen, and multinucleated inflammatory cell infiltration. Pathological changes of colonic mucosa and small intestine is similar. After the patient recovered, the disease can return to normal. Extension and gallbladder infection, can cause acute and necrotizing cholecystitis, gallbladder wall thickening harden, and can appear flattened mucosal surface ulcers, necrosis of the gallbladder wall microscope, accompanied by multinucleated cells infiltration. Cryptosporidium infection in the lungs of patients with lung biopsy specimens can be seen in the activity of focal interstitial pneumonia, bronchitis and other diseases. Invasive alien Cryptosporidium human intestinal epithelial cells at the edge of the brush-shaped formation of the parasitophorous vacuole is satisfied. Proximal jejunum, the largest number of parasite infection site. Infection due to spores oocysts, about 80% of the incidence and clinical manifestations. While the rest of subclinical infection, since the stool
Cryptosporidium oocysts discharged, the disease incubation period of 1 week or so. Serious infection, intestinal villus surface, there may be depression, wither, shorter thicker or fusion, displacement and expulsion; mild infections, intestinal pathology is not obvious. Pathological changes in the intestinal mucosa damaged the normal function of the small intestine, resulting in digestion and absorption disorders and diarrhea. If the diarrhea patients diagnostic stool Richard the oocysts can be confirmed. Since unstained oocyst colorless, transparent, and easy with the specimens in the confused non-specific particles, it requires the use of staining methods of diagnosis. Specific methods are: 1. White with green fluorescence slightly, the central stained light, like magic ring. 2. Improved staining acid-fast staining, the specimens were blue-green background, oocysts of rose red, visible internal structure. Drawback of this Law by staining specimens exist in non-specific macro-acid particles easily confused with the oocysts is difficult to identify. 3. Auramine phenol acid-fast staining of the Mother of this Law can be used to overcome these shortcomings of staining. Law first stained with auramine phenol, and then switch to modified acid-fast staining method stained. By optical microscopy, oocysts stained with acid fast but non-specific findings were dyed blue and black particles, the two different colors, easily identified, so the detection rate and accuracy greatly improved. 4. Immunological diagnostic methods of fluorescent monoclonal antibody and enzyme-linked immunosorbent assay. These two methods are city sales kit. Both have a high degree of character and sensitivity. In addition, abroad detected by PCR in stool samples oocysts were reported. 1 treatment, supportive treatment of intestinal infectious diseases by isolated severe symptoms should be hospitalized. Patients can cause severe diarrhea and electrolyte imbalance, is important to note corrected. Immunocompromised persons should be strengthened to support treatment. During the onset of lactose to avoid the consumption of food containing fat and more food to help alleviate the symptoms. 2, the pathogen has no treatment is effective anti-Cryptosporidium drugs that have a certain effect of the drugs spiramycin, clindamycin, azithromycin, garlic and so on. Some critically ill patients using spiramycin, can ease the condition, reduce diarrhea, but can not prevent recurrence. Adult dosage of 2-4g / d daily for 50-100mg/kg ,7-10d for a course of treatment. Children Allicin 20mg / time, 3 times a day, adult 40mg / times, 4 times a day, course 7-10d. 3, immune therapy, immune dysfunction in Cryptosporidium patients, as far as possible to rebuild their immune function is key to successful treatment. Some people have used high titer immune bovine colostrum, the treatment of AIDS patients complicated with Cryptosporidium, the symptoms have eased, but the effects are not yet sure. Cryptosporidium disease prognosis and patient prognosis is closely related to immune function. Normal immune function, there is self-limiting disease, the prognosis is good. Defective immune function, serious condition, prolonged course, difficult to completely remove parasites. Among AIDS, cryptosporidiosis is often difficult to control and ultimately can lead to death. Disease patients and sick animals to prevent oocyst contaminated water, food is Cryptosporidiosis spin the population the main way, so strengthening the management of human and animal feces, pay attention to personal hygiene and food hygiene to prevent the foundation of the epidemic measures. For immunocompromised people, especially people with AIDS to enhance the protection, in addition to enhancing immune function, the promotion of drinking water (heating minutes to kill the oocyst) is an important measure to prevent infection. Milk drinking should be disinfected. For the treatment of this disease there is no ideal effective drugs. Allicin treatment for domestic use, there is a certain effect. Foreign reports of oral paromomycin to 2 weeks, reduce the number of oocysts discharged, but the long-term efficacy is still uncertain. Since the pathogen of the disease there is no treatment effect, therefore, preventive measures and epidemic control Benbingfasheng particularly important. Should strengthen the management of patients with sick animals, avoid with animals with diarrhea. Institutional strengthening to improve the resistance is the main preventive measure. Attention to personal hygiene to prevent patients, sick animals fecal contamination of food and drinking water, patients used the potty to be immersed in 3% bleach for 10-15min after the cleaning of the clothes were contaminated with the stool of patients and other safety tips can be sterilized by boiling 1 on the patients immune intervention is necessary to stop the use of immunosuppressive agents, immune function and recovery, has led to many cases completely eliminates the intestinal cryptosporidiosis. 2, the purified parasite antigen concentration to obtain high-pregnant cows immune colostrum (hbc) containing high titers of anti-Cryptosporidium antibodies that prevent and treat animal and human cryptosporidiosis. 3, to avoid water pollution, drinking water is the most important preventive measures. Epidemiology Prevalence: Cryptosporidium was a worldwide distribution, in Australia, the United States, Central and South America, Asia, Africa and Europe have cryptosporidiosis epidemic. Diarrhea patients in various regions of Cryptosporidium detection rate ranging from 0.6% the lowest, the highest up to 10.2%. Since the domestic Korean Fan (1987) first reported 2 cases of Cryptosporidium infection, many provinces and cities nationwide successively carried out a survey of different sizes. To the beginning of 1998, a total of 44,789 people search, find infected 938 people infected in 19 provinces (autonomous regions and municipalities). In addition, in 14 provinces (autonomous regions and municipalities) 20,977 cases of diarrhea among children infected with Cryptosporidium were 449 cases, the infection rate is 0.917% -97% range. The average infection rate was 2.14%. Jiangsu, Yunnan, Shandong, the average rate was 0.38% -15.21%. Hunan, Guangdong, Jiangsu, Yunnan Province, 4, normal (12 592) the average rate was 1.62%, of which 2.01% of children (166/8259), was 0.877 percent of adults (38/4333). According to Bin Cheng Xun and Ling Meilin (1988) statistics, in Hong Kong found that human Cryptosporidium infection in 14 cases (10 cases found in 1995, 1996 4). Cryptosporidiosis is an important cause of human diarrhea, one of the reasons. Parasitic diarrhea in the first or second place share. Human infections may come from domestic animals. Outbreaks common in cows after with patients or populations, or occur in kindergartens and nurseries where children gather. According to reports, a nursery in Florida in 84 children, 33%, 18 staff, 22% of carrying the egg sac. Children than in adults susceptible to infection in children, non-breastfed infants susceptible than breastfeeding. In a hospital in Victoria, Australia, in the 884 gastroenteritis patients, 4% of the infection cryptosporidiosis. Survey shows that the surface of water throughout the United States of Cryptosporidium oocysts in the pollution rate of 65% -70%. Oocysts of conventional chemical reagents used for drinking water disinfection such as chlorine, are highly resistant. It is not contaminated with water in an effective measure to eliminate oocysts. Syndromes the severity of clinical symptoms in patients with immune states. Normal immune function after infection of the insects that often appears self-limiting diarrhea, watery stool, a large amount of pain may have abdominal cramps, nausea, anorexia, fever and general malaise and other symptoms. Course of the disease usually lasts 1-2 weeks, the symptoms will gradually reduce or dissipated. Course in 1 month or more are relatively rare. Stable clinical symptoms, the patient was still fecal excretion of the oocysts for several weeks. Patients with abnormal immune function, as the gradual onset of disease, but often more severe the degree of diarrhea, stool per day up to 5-10L. If the status of the patient's immune defects are not corrected, will not be able to clear the infection. Diarrhea, long-term or even life to continue. Then lead to nutritional malabsorption, extraintestinal tissues or even organs, such as lung and biliary infection. In sputum samples of lung tissue and in bile Richard parasites. Particularly noteworthy is that Cryptosporidium is an intestinal infection Ai Zi Patient common pathogens, infection is often endanger the lives of patients. Haiti and Africa in Europe 50% of AIDS patients complicated by infection of the insect and cause diarrhea. U.S. infection rate of 8% -37%. (Vakil, 1996) and most of intractable diarrhea. AIDS patients with Cryptosporidium infection caused by diarrhea, cholera-like watery diarrhea showed a day up to ten times, and watery diarrhea per day, or up to 3-6L. Up to 17L, which can cause patients with severe dehydration, electrolyte imbalance and malnutrition. Ultimately a result of systemic failure and death. Therefore, the foreign inspection Cryptosporidium has AIDS patients as a routine examination.


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